Where Intent meets Tactic

After applying for the graduate entrance, CFY, and for every job after this step, you can expect an interview and matriculating process to ensue. You may wonder what to expect and what tactics to use. If you haven’t yet mastered the interview, I help out with that in my book: Tattletales of a Speech Language Pathologist. Essentially, I just have to say… bring YOU. You already have everything you need to hold this sucker down, you just need a little flair and a lot of confidence. 

Confidence doesn’t equate to acting like a hot shot or that you know everything you in fact, do not. I’ve been unafraid to say “I don’t know” at interviews. Most times, I stated that under a certain circumstance, I can expect to do blank blank blank; however, I understand that there may be other ways to handle such a situation. A hot shot doesn’t leave room open for guidance and is likely not that teachable; there’s no worse trait for an employee. Rather than deal their cards at the risk of what the heck you could turn out to be – hey, maybe you are a great therapist – it’s safer to take someone who knows nothing, and who they can mold.

Tangentially, take care to making promises that you can’t keep up with. Whether it’s something that requires a skill, or something that requires too much of your time, any unmet promises reflect poorly on you and may even jeopardize your position or your license. For instance, in response to “Would you be comfortable working a 60 hour week every week for 52 weeks of the year?” you should not say yes because you want the job. Say no and explain that although your work is very meaningful to you, you also value balance so that you can bring your very best self to work every day. You may be willing to negotiate scheduling and paid time off to satisfy a need that the company has, but it would not be possible or reasonable to make that commitment. The fear of having a company choose another candidate is STRONG, I feel it every time. It’s professional FOMO. I actually have this weird way of immediately saying “I accept…” and experiencing a weird chill of regret right after. The truth is that it’s extremely helpful to have the time to consider how a new position may uproot other plans or commitments you may have. Even if I had thought about it before, having the job offer in hand changes things. At times, I’ve followed up with …”unofficially” and stuttered my way through whatever excuse I could use to delay the process. I might have said I would like to ask a few more questions or see the facility. Don’t be like Suleika. Take the time to be sure.

Lately, it’s been the case that most interview processes start off with the interviewer answering many questions I hadn’t even thought to ask yet. I could tell they loved my resume because they seemed to be trying to impress me in return by telling me all the wonderful reasons I should work with them. Alternatively, I also had an interview that started off with the interviewer warning me about how hard a position might be to obtain or keep, as the nature of the work was very stressful.

One shouldn’t expect that the interview will be hard or worthy of an anxious breakdown just prior. It’s not an exam. Still, to impress an interviewer, there are some things one should prepare to be questioned about and ready to respond to.

Sometimes, but not often enough, I was asked why I was the right person for the job. To best answer this question, it’s important to know the ideals of the workplace and about the activities that are most beneficial for the population you’ll be servicing. It is a personality question, as well as knowledge-based one. There is no specific right answer, but one surefire way to let an interviewer know that you are wrong for it is to use some generalized list of traits about yourself or to not have any idea of what your clients will need from you.

I was never asked what my feelings were towards my then current position, why I was ready to leave it, or how I was sure this position would be any different. I might have had an answer ready for these sometimes, but even then, I imagined that the interviewer would have seen right through me or devalued whatever answer I gave. It was a personal issue of self-confidence and anxiety, really. Do yourself one better than I did and shoo those feelings. Your interviewer knows that there is a reason you are looking for a better opportunity. If asked, perhaps honesty is the best policy, but what if your reason for leaving is your fault or makes you look bad? My Tattletales advice could be to restructure and retell the story in your own favor, but there is a positive outcome of retelling your mistakes and what you’ve learned. The interviewer will see a person who is not only teachable, but seeks understanding and resolution when mistakes are made… and we all know they will be!

While I received at least one dysphagia therapy or evaluation question during the interview, I was never asked actual speech modality therapy questions. I was certainly never given anything such as outlining a therapeutic plan on the spot, and to date I can recall being given one single case study question. I mean, I really thought the PRAXIS was going to come back to haunt me each time, and it didn’t. That’s not a reason not to stay prepared. A little research may go a long way in your interview, and even if you still aren’t sure of the answer, you have more to share than the person who didn’t even think to get a quick blurb from Google.

I was asked other questions I wasn’t ready for, but somehow killed with great responses that surprised even me. They were questions that made me reflect on why I decided to serve a certain population in the first place, and I recalled what my biggest challenges were in a certain setting or with an individual client. They were questions that, when I answered, I reassured myself I was making the right move. Interviewers liked me because they saw I brought myself and my passion to the interview, aside from just a little bit of knowledge.

After all, the interview is a two-way street. Interviewers know what they are looking for. It could be just a body to put in a position, and you’ll know that when they ask checkbox questions and do not use the time to get to know you or have a conversation. Alternatively, they could be looking for someone to set a new course of things around a system that is developing, and this really allows you to bring your experience, ideas, and charm. Your personality leads this interview.

For someone early on in the field, it is most important to keep in mind what you are looking to achieve, rather than to bank on what you feel you’ve already achieved. The truth is, there are plenty more experienced professionals applying who are well qualified, who may still not necessarily be a better candidate than you, for any variety of reasons.

Give yourself the benefit of the doubt, and grasp opportunity barehanded by the horns. You deserve all those that come charging at you blindly, and will learn to balance them with those that you seek out and diligently pursue. Come with YOU first, and everything else will follow.

The Billing Crisis

One thing nobody tells you about in grad school is how heavily money drives service provision. You know that in order to survive, businesses need to make money, of course – but does it have to be a big red boxing glove uppercut in your chin big deal? Well, different settings have different ways of managing billing situations and your money isn’t necessarily always tied up in that confusion, but most recently for me it has. Coming from the SNF (skilled nursing facility) setting, where my hours may not have always been guaranteed, my time was always compensated without question or confusion. If I clocked in and clocked out, I received my hourly pay rate whether or not my billing and notes were all done properly. While that is never an excuse to slack on either billing or notes (don’t go and get fired!), it seemed fair. Taking my talents over to EI was not this way… at all. There was no clock machine, and I sure as hell wasn’t paid for the in-betweens including travel, phone conversations with other providers, advocate letters for families, nor the occasional drag to leave a child’s home when the parent has tons of questions that they don’t ask until after you’ve already completed your 30 mins. I decided that because each session paid an erroneously high amount for 30 mins of play time, all of those things were essentially priced in. Well, in the month of September, I was smacked in the face to learn that no it was not effectively priced in, and furthermore I might not get paid at all after I failed to fill out billing documents to the satisfaction of the agency’s billing coordinator who works with Medicaid for reimbursement. She returned THIRTEEN session notes marked with red circles and Xs and scribbles, bringing me back to the memory of 5th grade English class book reports. The agency clinical director put me through a mandatory retraining and advised me to return all documents ASAP to reduce delay of my payment. What else could I do? I worked tirelessly to redo the notes, but they were still imperfect. In the next billing cycle, I had 8 more notes returned, continuing on in the silly cycle. I legitimately missed session appointments just to ensure I got it all together. I drove to houses at odd hours, just to collect parent signatures the second time around. Still, two months after making EI my full time job, I had not received a PENNY for my services provided. If this sounds like an introductory episode to how to get away with murder, it’s definitely because I was sharpening the knife and polishing my steel toed boots. To be continued…

Wardrobing for In-House EI

As a follow up for my recent post on pants-less Early Intervention.. I mean the Telehealth to In-Person Transition, I wanted to write a short how-to for choosing your work wardrobe. 

On a long day, I realize there are not only temperature changes outside, but also inside the homes. Some people love heat 😅 and while I do too, some kids will have you running up and down hallways and lifting their too-heavy-for-age-2 bodies above your head several times in a 30 minute period. Let’s not get into jumping, spinning, and stomping like an elephant – it gets to be a bit much. It’s recommended to wear removable layers in the event that the heat (or cold) are a bit beyond your threshold. 

I have kids that grab and hold on tight, which could be because they’re angry or they’re just very excited to see me. Care for wearing long sleeves (can be breathable fabric), buns over ponytails or loose hair, and absolutely NO V necks! I know I mentioned layers but it should really be a consideration to wear an undershirt as a precautionary measure if ever you are sitting on the floor, bending, or lifting up high that the entire family doesn’t necessarily have to enjoy your midriff. Ladies, aways wear a bra, and I don’t have to tell you why. 

Pants, whether shorts (near the knees please) or long pants should pass the buttcrack test. Don’t be that guy. If you live in a warm place, you may be tempted to wear loafers or flip flops/sandals often which is no problem. If you do so, have a handy dandy pocket with extra socks. Don’t ever put it past a family that they may not want you to wear shoes in their house. I know my house is outside shoes free, and because I walk around my house barefoot, I have tried this in other homes and when I tell you I was so regretful sometimes, when I realized the dirt or other particles that cane in contact with my skin!? 

I don’t wear jewelry, but for those of you who do… well, DON’T 🤷🏽‍♀️. There isn’t a single safe piece of jewelry that I can think of that should beyond a reasonable doubt enter the home of a 0-3 year old client. If you must, make sure it passes the poke and pull test (i.e. that it will not scratch, cut, or bind anything on the child’s body if they try to grab you). 

Surprisingly, I find that long nails (for my long tips queens) is not a no-no for EI Therapy. Let’s be real, while the mundane look works for EI kids for a reason, you have a life outside of those homes and nails cannot be repetitively put on or taken off like jewelry can. With care to the kinds of activities you’ll be doing, long nails should generally hold up well during the session and do not typically pose any unnecessary danger to the child (just try not to poke an eye out). A fun positive – long nails make noise on solid surfaces and is a great attention grabber during session time. Use it to your advantage. 

I wish I had advice for glasses, but I don’t ever wear them, except for those silly ones with the big nose and furry eyebrows I use to get some extra eye contact during activities. They always get ripped off, so perhaps if you don’t need the glasses, don’t bother with them just for fashion.

Your mask will be also be ripped off at some unexpected time, without a doubt, if you work with children. Carry more than one, in the event it falls on the floor, gets coughed or sneezed on, or the child runs with it and you can’t catch them, you at least have gave a backup.

Thanks for coming to my Ted Talk. Have a great day.

Telehealth to In-Person: Rocking the Boat

At the start of August, I made my second major decision in my career. Starting EI full time! While it should have been exciting… duh, I’d be playing with babies all day… it was actually more nerve wracking than anything else. We’d been living in unsure times as a result of the global pandemic that riddled my life with broken self-promises, economic instability, emotional and mental stressors, etc.

My introduction to EI was not a great one. I began back in March on a rocky path on which everything I had trained for (in-person services) was switched up and next thing I know, I’m seeing my first children over a phone screen. The logic is essentially, “easy, I can do this from the comfort of my home and I don’t even have to wear pants (TMI) if I don’t want to”. I hated it. It seemed like the most useless way to connect with babies – they couldn’t even sit in front of the camera properly!

Slowly but surely I got a grasp of working with the parents and being flexible about my approach to applying techniques and stimulation over telehealth. Interaction with the camera was less and less important to me, as I became better at guiding the parents to do what I couldn’t. However, an even more difficult task than carrying out the session itself, was getting families to show up for the session. I received cancellations out the wazoo, and it could be for any variety of reasons – the child is napping, the battery isn’t charged, the place is too loud, the dog ate their homework and then a whale swallowed all the pieces ro their alphabet puzzle. You name it. Being in the midst of a pandemic, I tried to be understanding of crazy work schedules, and would change, reschedule, or switch around activities in my own life to make it work. Still, I was left hanging so frequently that sometimes I would only see 1/10 of my sessions planned for the week. When I was transitioning into EI full time, I went in with a dollar and a dream hoping that my in person experience would be different than what I had with telehealth. Thankfully, It turned out it was a complete flip of the switch. Even my telehealth cases got better, but they weren’t numerous for clear reasons. Making my own schedule came with great perks, but it was a bit of a headache when subtle changes or obstacles would throw everything off! Traffic, bad parking, or a bit of untimely gas…

I was at my best when I chose cases that were extremely close together and gave me time to navigate one neighborhood before moving onto the next. The give or take 15 minutes rule had to come into place after I got tired of apologizing for being late. It turned out I wasn’t the only one with this kind of rule. The PT treating one of my babies commuted from Staten Island to Brooklyn, and bitterly apologized, explaining that he had a give or take ONE hour rule, for which he effectively ruined my morning schedule.

I was also at my best when I followed a rigid organization schedule. I tried to keep up with a log to track every single bit of my spending  (miles, gas prices, parking fees, materials prices) for hopeful reimbursement and write-offs around tax time. I made it a big deal – after reprimanding – to have session notes written, signed, and delivered on time, and to ensure each note was free of error (see: The Billing Crisis).

Honestly, even at my best, I still struggle with the in-person transition. I loveeee my kids but each day I struggle with the fact that I am not getting paid like someone who is now doing real work!  If anyone tells you they’re in EI for the babies, and not the money, they’re trifling and lying all at the same time. EI money is just as beautiful as those little smiles you create… or so I thought. Getting into EI under an agency meant a need for having cushion money – which I didn’t… incredible organizational skills – which I didn’t… and a desire to work twice and get paid once – which, I mean come on now!

Telehealth was a steal and I didn’t even know it until I was transitioning to in-person. Still it isn’t quite my teaching style. Although I’ve maintained a couple of my telehealth cases, I still find it rare to have a session that feels whole, or even truly progressive. For about half of the time, I am observing play with only intermittent commentary or question. During the other half, I am giving more structured activities for the parent to carry out and giving feedback and suggestions more frequently. I don’t have my babies doing anything interactive over the screen because they aren’t suitable candidates for this approach… actually, so far, only one child has proven to be. And that’s okay! With the way things are going in NYC, telehealth is still a very viable option. While not quite the best option for me for this population, it offers a way to better manage time, money, and materials. I’m sure we can also agree the best kinds of freedom include a bedside workstation with no traffic, nor pants or socks required.

Danger: Falling Too in Love

No this isn’t a relationship blog, but listen, there is no successful career where passion doesn’t exist.

Lately, my life has been nothing but Work, Book, and Sleep. Work, Book, and Sleep. Every once in a while, I take some self care measures to enjoy the pleasures of the outdoors, interpersonal relationships, and physical activity. But somehow in all of those things, I am not finding myself entirely engaged or free – I’m so determined to get myself on a path, that it’s living in my mind that those things are distractions rather than simply things I need to keep around me to keep myself sane. On tangent, yes, I’m an advocate for mental health care and mental self care. Get it how you live it, but make sure you don’t forget it or give up on it.

With ALL what’s pressing on my mind in these times, I am especially focused on finding myself and my place in this field. It causes me to chuckle how about 3 months ago, I was looking for a job – any job outside of speech pathology. It’s a long story, and as we get to know each other better, you’ll understand how much of a love/hate relationship I have had with this field in my first two years of officially practicing. 

Writing and publishing a book has been something I’ve wanted for literally as long as I can remember. I have written fictionally and journaled about my life since I was able to hold a pencil. I have never been brave enough to share, so all of this is new to me too.

With what I’ve been learning about the publishing process, I’m realizing I am not too far off from similar lessons learned as a therapy provider.

Things. Take. Time. Inevitably. Uncomfortably. You don’t always have full control, and when you do, you lose out on the opportunity to take what someone else has to offer to your process. 

It’s not all bad to take a step back and reconsider an original idea or design. It’s a growing and living being – a dynamic process. I don’t take for granted how getting used to “change” has changed my life. 

Speech path, rather any journey you take on will be littered with obstacles you didn’t imagine. But also, you may not like everything as much as you imagined you would. 

I have chopped, screwed, flipped, and bled out my original ideas of what I wanted from all of this. Me ten years ago, me today, and Me ten years from now, I can imagine will be three distinct personalities wearing the same face and petite body. At first, I would have been disgraced to know that I wouldn’t have stuck to everything I said I would, been mad at future me for getting distracted. Now, I seek out opportunities to get lost and wander in dark places, because no natter what I see nothing but golden sun at the end of the tunnel. I can’t help it, my faith is too big.

I say all this to say, Don’t be resentful of the process. It’s all necessary. Fall in love, not with the way things are “supposed to go” but with each and every step you take along the way.

Quitting My First SLP Job

2020 has been big, long, uncomfortable, too hot or too cold kind of year. This year has taken us all through literal storms of grief and despair. I’m lying if I say that it’s been the worst thing that happened to me; quite honestly, it might have, for these reasons, been the most necessary era I had to go through. I paid my dues in the SNF for a year and a half before I knew for sure I needed to get out. Yes, like an episode out of Jordan Peele’s repertoire. OUT. The plan was just about set and ready, absent of me actually having a decent job replacement. I wanted to travel for 6 weeks in a part of the world that gives me the good kind of shivers. I was sure that things would figure themselves out. An act of God or a pursuit of the devil, I truly don’t know. But March came, then April, then May, and leaving a job when so many were struggling to keep theirs, seemed more selfish and stupid than anything else. In my Tattletales, I walk through far more detail of this period of strife. I lend it to ALL of that, that I got good and ready to completely flip the switch. The events leading up to my resignation were interesting, twisted, and confusing. I don’t think I’ve ever put in a two week notice before, less a full 30 days. These 30 days were the longest I’ve ever experienced. From the outside, it seems as though nothing is going on. On the inside, I have a plethora of doubts, a constant replay of everything leading up to this point, unanswered questions, feeling like I’m walking down a twisted stairwell with a blindfold. This is unlike me. When it comes to a job I hate, or even one I like that’s just not meeting my needs quite as well, I have no problems signing off and saying my final toodleoo. Why were things so different this time? I left the building with tears in my eyes and fear that I felt in my bones. Come my first Monday as an unemployed (well, partially employed) SLP, I was just happy to sleep in. Then the Monday after that, I came really close to using my “hey big head” line to get my foot back in the door. Toxic relationships die the hardest. Mondays have since been really smooth, and it helps a lot that I make my own schedule. Nothing at all beats that. I say all this to say, fear nothing but a comfort zone. “Timing” and faith are all we have but they are not equals. When I ran out of patience waiting for the right time, I just relied on what I had left. So far, so good.

So, What’s the Story Anyway?

Ages ago, no one could tell me I wasn’t going to be a doctor… not just any doctor, but an animal doctor. I’ve never had a pet aside from my goldfish Flipper. I don’t know what led me to this early decision to seek out veterinary medicine; maybe it just sounded cool, but years later I’m everything but what I thought life had set out for me. I’m happy for myself, but also extremely nerve wracked over it all. I don’t have a true recollection of my emotional settings at the beginning of my CFY. A lot was going on, so perhaps a rollercoaster of “Wee, grad school’s done”, loop-dee-loop of “Am I doing this right?” and a screaming roar from the top of “This isn’t what I saw coming!!!!” all hit in the same short duration of time.. and then over and over again until… well, let’s just say I’m still riding this ride without a seatbelt and well under the height requirement. I’m putting my big ol’ foot into this CFY pie called Tattletales of a Speech Language Pathologist – my new book and my new brand. My aim is to guide myself and a number of YOU beautiful people through a journey that no one in our position can take lightly. It’s our bread and butter. Okay, okay, analogies aren’t always my strongest point but it suffices for the speech therapy. It is the foundation we build on for years and years and more years as we fall more in love with our crafts. There are tons of places with tons of information and opportunities to help chisel and tone our skills and experience. You definitely want to get the book if you’ll be in a SNF, and if not, still subscribe for blogs, access to advice column, and my opinion column. This road does not have to be traveled alone. Journey with ME! You won’t regret it.